How much rates vary
Facilitymedian $126 · 10th to 90th $39 to $389Professionalmedian $41 · 10th to 90th $25 to $47
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | None | $35.48 | $35.48 | $38.90 |
BCBS Idaho Setting Facility Modifier None Typical Low $52.48 Median $125.89 Typical High $389.05 | Facility | None | $52.48 | $125.89 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $41.69 | Professional | None | $24.55 | $24.55 | $41.69 |
Moda Health Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $50.12 | Facility | None | $35.48 | $35.48 | $50.12 |
Moda Health Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $47.86 | Professional | None | $30.20 | $38.90 | $47.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $42.66 Median $46.77 Typical High $46.77 | Facility | None | $42.66 | $46.77 | $46.77 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6.17 Median $44.67 Typical High $46.77 | Professional | None | $6.17 | $44.67 | $46.77 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $416.87 | Facility | None | $218.78 | $309.03 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | None | $40.74 | $40.74 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $24.55 Median $25.12 Typical High $125.89 | Facility | None | $24.55 | $25.12 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $54.95 | Professional | None | $24.55 | $37.15 | $54.95 |
United Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $50.12 | Professional | None | $25.70 | $33.88 | $50.12 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $19.50 | Professional | 52 · Reduced service | $17.78 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.94 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $38.90 Typical High $40.74 | Professional | 78 · Unplanned return to OR | $28.84 | $38.90 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $19.50 | Professional | 52 · Reduced service | $17.78 | $17.78 | $19.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.94 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.89 |
Where Idaho sits
The same service costs 2.5 times more in Minnesota than in Arkansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 15th of 51
$40.74
MN $63.10AR $25.70
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.